Exam 6: Units 11, 12, & 13 Flashcards
(232 cards)
1
Q
part of the brain that coordinates the production and release of hormones
A
hypothalamus
2
Q
this gland secretes hormones that regulate most of the other endocrine glands
A
pituitary gland
3
Q
endocrine function of the pancreas
A
secreting insulin and glucagon to regulate blood glucose levels
4
Q
exocrine function of the pancreas
A
secretes enzymes for digestion such as amylase and lipase
5
Q
glucagon is released from
A
pancreatic ALPHA cells
6
Q
insulin is released from
A
pancreatic BETA cells
7
Q
after a meal, the digestive system breaks down carbohydrates to simple sugars called
A
glucose
8
Q
Insulin is produced in the pancreas by
A
Islets of Langerhans in the beta cells
9
Q
process that generates glucose from non-carbohydrate sources such as proteins, lipids, pyruvate, or lactate
A
gluconeogenesis
10
Q
process of breaking down glycogen into glucose for energy
A
glycogenolysis
11
Q
for a non-diabetic patient, a fasting glucose of ______ is normal
A
60-110
12
Q
a patient can be diagnosed with DM if this glucose reading is given on 2 separate occassions
A
at or above 126
13
Q
pre-diabetes glucose reading (must be consistently for dx)
A
100-125
14
Q
HbgA1C AKA
A
glycosylated hemoglobin
15
Q
a HbgA1C of ______ must be taken for a DM diagnosis
A
6.5%
16
Q
expected HgbA1C for a non-diabetic person
A
4%-6%
17
Q
HgbA1C reading that is considered prediabetic
A
5.7% - 6.4%
18
Q
acceptable HgbA1c range for diabetic patients
A
6.5% - 8%
19
Q
TARGET goal of HgbA1C for a diabetic patient
A
less than 7%
20
Q
an HbA1C of 6% correlates with this blood glucose level
A
126
21
Q
an HbA1C of 7% correlates with this blood glucose reading
A
154
22
Q
an HbA1C of 8% correlates with this blood glucose reading
A
183
23
Q
an HbA1C of 9% correlates with this blood glucose reading
A
212
24
Q
an HbA1C of 10% correlates with this blood glucose reading
A
240
25
3 P's of hyperglycemia
Polyuria
Polydipsia
Polyphagia
26
excessive urination
polyuria
27
feeling of extreme hunger
polyphagia
28
feeling of excessive thirst
polydipsia
29
a patient may have these kinds of respirations with hyperglycemia
Kussmaul respirations (deep, labored)
30
a fasting blood glucose of _____ indicates hyerglycemia
>125
31
a postprandial blood glucose of _____ indicates hyperglycemia
postprandial: after lunch or dinner
>180
32
this test is the average blood glucose level over the previous 2-3 months
HbA1C
33
the non-diabetic goal range for the HbA1C
4% - 6%
34
hypoglycemia is a blood glucose of
70 or less
35
this hormone taps into glucose reserves to release it to the blood
epinephrine/norepinephrine
36
pancreas releases _____ to raise blood glucose
glucagon
37
3 key clinical presentations of hypoglycemia (think brain)
confusion
mental fogginess
poor cognition
38
newborns will have an initial ____ in glucose
drop in glucose
39
a healthy newborn can tolerate a blood glucose of
30
40
this IV fluid may be given to a patient experiencing hypoglycemia
dextrose
41
genetic, autoimmune disease involving the death of beta cells in the pancreatic Islets of Langerhans
T1D
42
T1D usually occurs in (age range)
adolescence
43
3 P's of T1D
Polyuria
Polyphagia
Polydipsia
44
a patient with T1D may have this non-fasting blood glucose reading
200
45
a patient with T1D may have this fasting blood glucose reading
greater than or equal to 126
46
a patient with T1D may have an HbA1C of
greater than or equal to 6.5%
47
C-peptide levels with a patient with T1D will be
decreased
48
serum ketones will be _____ in T1D
present
49
a patient with T1D will have a blood gas pH _____ than 7.35
less than 7.35
50
a T1D urinalysis will be positive for both
glucose and ketones
51
an HgbA1C should be tracked every
3 months
52
diabetic patients who are sick should increase their
blood glucose monitoring
53
a diabetic patient who is sick should never omit
their insulin
54
a diabetic patient who is sick should drink plenty of
fluids
55
a diabetic patient who is sick needs to contact their provider if blood glucose reaches this level, or if this is identified in the urine
> 250
ketones are present in urine
56
regular insulin is diluted with
normal saline ONLY
57
lispro and aspart insulin are (class)
rapid-acting insulin
58
regular insulin is (class)
fast-acting insulin
59
NPH/isophane insulin is (class)
intermediate-acting insulin
60
glargine and detemir insulin are (class)
long-acting insulin
61
onset of lispro
15-30 minutes
62
peak of lispro
30 min - 3 hour
63
duration of lispro
3-5 hours
64
onset of regular insulin
30-60 minutes
65
peak of regular insulin
2-4 hour
66
duration of regular insulin
4-12 hour
67
onset of NPH insulin
1-2 hours
68
peak of NPH insulin
4-12 hour
69
duration of NPH insulin
14-24 hour
70
onset of glargine
2-4 hour
71
peak of glargine
NO PEAK FOR LONG-ACTING
72
duration of glargine
up to 24 hours
73
only kind of insulin that can be given IV
regular
74
1st line oral hypoglycemic medication for T2D
metformin
75
metformin is contraindicated in (x2)
renal impairment
metabolic acidosis
76
Some T2 diabetics are insulin dependent. Another medication that can be used is
GLP1 to increase insulin sensitivity
77
DKA is typically seen in this kind of DM
T1D
78
Hyperosmolar Hyperglycemic State (HHS) is typically seen in this kind of DM
T2D
79
DKA has a pH of (think acidic)
<7.35
80
this electrolyte imbalance accompanies DKA
potassium imbalance
81
a person with DKA may have this kind of breathing pattern
Kussmaul respirations
82
HHS has a pH of (basic)
>7.4
83
there are more profound ______ manifestations with HHS
neurological
84
HHS is a _____ disease
thromboembolitic disease - increased clot risk
85
there is SIGNIFICANT ______ in HHS
dehydration
86
a person with HHS may have this kind of electrolyte imbalance
potassium imbalance
87
a key s/s with DKA is a
flushed face
88
nurse should administer these 4 things to a patient with DKA
1) FLUIDS
2) Insulin
3) Potassium
4) Bicarb - assess need first
89
onset of HHS is _____ than in DKA
much slower
90
serum and urine ketones are ______ in HHS
absent
91
serum and urine ketones are _____ in DKA
present
92
mortality rate for DKA
1% - 5%
93
mortality rate for HHS
10% - 20%
94
main goal in treating DKA and HHS
restoring circulatory volume
95
part of treating DKA and HHS is treating
hyperglycemia
96
goal range for potassium when treating DKA and HHS
4.0 - 5.0
97
sodium is corrected in DKA and HHS using
IV fluids
98
main health condition that contributes to metabolic syndrome
insulin resistance
99
if metabolic syndrome is left untreated, it can lead to (x2)
T2D
Cardiovascular disease
100
main health impact of metabolic syndrome
damage to vasculature and nerves
101
waist circumferences that accompany metabolic syndrome (males and females)
Males: >40
Females: >35
102
2 medications that can be used for metabolic syndrome
Glucophage
Statins
103
outer layer of skin composed of mainly keratinocytes and other cells
epidermis
104
largest portion of the skin made of connective tissue, blood vessels, lymph vessels, nerves, sweat/sebaceous glands, and hair roots
dermis
105
subcutaneous fat that insulates the body, absorbs shock, and pads the internal organs and structures
subcutaneous tissue
106
this refers to interior body forces upon the skin when moving in the opposite directions and may result in deep tissue injury
shearing
107
a mechanical force caused by dragging the skin across a surface, such as changing position in bed
friction
108
3 phases of the wound healing process
1) Hemostatic/Inflammatory
2) Proliferative
3) Remodeling
109
phase of the wound healing process where new collagen fibers are formed, a new wound bed is created, and new capillaries are formed
Proliferative
110
phase of the wound healing process where stronger collagen replaces the gelatinous collagen
remodeling
111
phase of the wound healing process where damaged tissue releases cytokines, which trigger blood coagulation, and the wound begins to heal
hemostatic/inflammatory
112
type of wound healing that involves the skin being closed with adhesives or sutures
primary intention
113
type of wound healing that involves the wound being left open to view
second intention
114
type of wound healing that is a combination of primary and secondary intention, where the wound is left open for 5-10 days before being closed with sutures
tertiary intention
delayed primary closure
115
second intention requires a _____ healing time compared to primary intention
longer healing time
116
two types of wounds
acute and chronic
117
incisions, skin tears, abrasions, and moisture-associated damages are this type of wound
acute wounds
118
arterial ulcers, venous ulcers, and diabetic ulcers are this type of wound
chronic wounds
119
excessive/hypertrophic wound healing can result in
keloids
120
this color of wound indicates healthy regeneration of tissue
red
121
this color of wound indicates presence of purulent drainage and slough
yellow
122
this color of wound indicates the presence of eschar, which hinders wound healing and requires removal
black
123
drainage is AKA
exudate
124
1 gram = ____ mL drainage
1 gram = 1 mL
125
type of drainage that is normal for the healing process, characterized by clear, thin, watery, and pale yellow appearance
serous drainage
126
type of drainage that is bright red, appearing as blood leaking from the wound
sanguineous drainage
127
type of drainage that is a combination of serous and sanguineous drainage that is pink/watery
serosanguineous drainage
128
type of drainage that is thick and foul-smelling
purulent
129
this type of therapy increases oxygen availability for wound healing
Hyperbaric Oxygen Therapy
130
when irrigating a wound, clean it in this order
from the least contaminated area towards the most contaminated
131
these. kinds of solutions remain the preferred cleansing agents for wound irrigation
isotonic solutions
132
procedure where biofilm and dead tissue are removed with a scalpel and scissors
surgical debridement
133
procedure where foam strips are laid into the wound bed with an occlusive sealed drape, suction with negative pressure is applied in attempts to decrease swelling and enhance healing in a moist environment
Vacuum-assisted closure system (wound vac)
134
partial or total rupture of a sutured wound, usually with separation of underlying skin layers
dehiscence
135
a dehiscence that involves the protrusion of visceral organs through a wound opening
evisceration
136
evisceration or dehiscence require
emergency treatment
137
the nurse should administer antibiotic therapy at this time
after collecting specimens for culture and sensitivity testing
138
most susceptible areas for pressure injuries
over bony prominences
139
pressure injuries are classified by
how much tissue loss is observed in the wound
140
stage of pressure injury with nonblanchable erythema of intact skin
Stage 1
141
stage of pressure injury with partial-thickness skin loss with exposed dermis. Wound bed is reddish-pinkish WITHOUT slough, eschar, or granulation tissue
Stage 2
142
stage of pressure injury with full-thickness skin loss, SOME slough and eschar is present
Stage 3
143
stage of pressure injury with full-thickness skin loss and tissue loss. Cartilage, bone, fascia, muscle, ligaments, or tendons are exposed
Stage 4
144
stage of pressure injury with obscured full-thickness skin and tissue loss
Unstageable
145
stage of pressure injury with persistent nonblanchable deep red, maroon or purple discoloration. Eschar or slough obscures staging.
Deep Tissue Pressure Injury (DTPI)
146
TIME mneumonic
T: Tissue integrity
I: Inflammation/Infection
M: Moisture
E: Edge of wound
147
this tool is used to assess the patient's risk of developing a wound ulcer
Braden scale
148
nerve damage due to uncontrolled diabetes
diabetic neuropathy
149
during inflammation, this series of events usually occurs (x3)
1) Vasodilation
2) Increased vascular permeability
3) Leukocyte cellular infiltration
150
5 cardinal signs of inflammtion
Heat
Redness
Pain
Swelling
Loss of Function
151
this is released by mast cells and causes vasodilation and vascular permeability
histamine
152
a group of substances that are released in response to injury that can cause vasodilation/increased permeability and attract neutrophils
kinins
153
a group of compounds released that can cause vasodilation/increase permeability, cause swelling, and cause pain
prostaglandins
154
2 types of inflammation
chronic
acute
155
condition that is characterized by a progressive deterioration of joint cartilage
osteoarthritis
156
osteoarthritis is not
inflammatory or autoimune
157
osteoarthritis has a ____ onset
slow onset
158
osteoarthtitic pain is usually
asymmetrical (affects ONE joint)
159
in osteoarthritis, the patient may feel pain/stiffness in joints at this time
after weight-bearing activities
160
this protects the ends of the bone, allowing the bone to move seamlessly over each other in a joint
articular cartilage
161
osteoarthritis occurs when there is damage to the ____ cartilage
articular cartilage
162
this gender is more at risk for osteoarthritis
female
163
in osteoarthritis, these nodes may present at the DIP of fingers
Heberden's nodes
"Heberden's are Higher on the finger"
164
in osteoarthritis, these nodes may occur at the PIP of the fingers
Bouchard's nodes
"Bouchard's are closer to the Body"
165
a main risk factor for osteoarthritis
(NOT the only risk factor, though)
obesity (increased weight/wear on joints)
166
medication of choice for managing osteoarthritis
acetaminophen
167
these medications can be used on a short-term basis for managing osteoarthritis
opioids
168
these two supplements can be taken for osteoarthritis
glucosamine and chondroitin
169
topical ______ can be used for osteoarthritis
topical capsaicin
170
replacement or reconstruction of the joint
arthroplasty
171
this is a chronic inflammatory type of arthritis, also an autoimmune disease
rheumatoid arthritis
172
patient with rheumatoid arthritis will have a
+ rhematoid factor
173
rheumatoid arthritis usually affects the ____ joints first
upper joints
174
rheumatoid arthritis has a ____ onset
rapid onset
175
pain associated in rheumatoid arthritis is located
bilaterally and asymmetrically
176
a person with rheumatoid arthritis will usually have joint pain/stiffness at this time
in the mornings
177
rheumatoid arthritis is a _____ disease that can affect any connective tissue in the body
systemic disease
178
this kind of rheumatoid arthritis affects joints and organs of children under 16
juvenile RA
(children CAN outgrow this)
(bone development is affected)
179
gender that is more at risk for rheumatoid arthritis
female
180
this virus may pose a risk factor for rheumatoid arthritis
Epstein-Barr virus
181
removal of synovium
synovectomy
182
joint fusion
arthrodesis
183
joint deformities are _____ signs of rheumatoid arthritis
late signs
184
2 types of finger contractures that are common in rheumatoid arthritis
Swan neck
Boutonniere
185
morning stiffness, joint swelling/deformity, and _____ are common clinical presentations of rheumatoid arthritis
subcutaneous nodules
186
this lab will be elevated in a patient with rheumatoid arthritis
ESR (erythrocyte sedimentation rate)
187
this blood cell count will be high with rheumatoid arthritis
WBC (inflammation)
188
this blood cell count will be low with rheumatoid arthritis
RBC (due to anemia)
189
synovial fluid aspiration
arthrocentesis
190
alternate this when treating rheumatoid arthritis
alternate hot and cold
191
3 classes of medications used to manage rheumatoid arthritis
NSAIDs
Corticosteroids
DMARDs (disease-modifying anti-rheumatic drugs)
192
complication of RA: autoimmune disease where the body attacks the glands that produce tears/saliva and result in drying of other parts of the. body.
AA: eyes, mouth, vagin
Sjogren's syndrome
193
inflammation of arteries that can disrupt blood flow, affecting mainly the smaller arteries of the skin, eyes, and brain
vasculitis
194
vasculitis can lead to
organ ischemia
195
disease that involves the buildup of collagen in the skin and other parts of the body
scleroderma
196
scleroderma is an _____ disease
autoimmune
197
gender more at risk for scleroderma
female
198
this kind of scleroderma only affects the skin on the chest, abdomen, or limb, but not usually the hands or face
localized scleroderma
199
localized scleroderma AKA
morphea
200
localized scleroderma/morphea develops
slowly
201
this kind of scleroderma may affect large areas of the skin and organs such as the heart, lungs, or kidneys
systemic scleroderma
202
systemic scleroderma AKA
sclerosis
203
there are two main types of scleroderma
Limited disease
Diffuse disease
204
Limited disease (systemic scleroderma/sclerosis) is associated with this syndrome
CREST syndrome
205
CREST syndrome stands for
C: calcinosis
R: Raynaud's
E: Esophageal dysfunction
S: Sclerodactyly
T: Telangiectasias
206
part of CREST syndrome characterized by calcium deposits on the skin
calcinosis
207
part of CREST syndrome characterized by a spasm in the blood vessels as a response to cold or stress
Raynaud's phenomenon
208
part of CREST syndrome characterized by acid reflux and decrease in motility of the esophagus
esophageal dysfunction
209
part of CREST syndrome characterized by thickening or tightening of the skin on the fingers and hands
sclerodactyly
210
part of CREST syndrome characterized by a dilation of capillaries causing red marks on the surface of the skin
telangiectasias
211
during an assessment, this kind of skin may indicate scleroderma
tight, thick skin on the fingers
212
during an assessment, if these appear on the fingers or toes, it may indicate scleroderma
ulcers on the fingertips or toes
213
these three parts of the body will be assessed for abnormalities when diagnosing scleroderma
heart, lungs, and abdomen
214
pharmacological treatment for scleroderma may include
corticosteroids
immunosuppressants (methotrexate)
215
for most people, scleroderma progresses like this
the disease gets worse, but slowly
216
type of arthritis caused by an increase of uric acid levels (hyperuricemia)
gout
217
two types of gout
primary and secondary
218
this type of gout is more common
primary
219
accumulation of sodium urate crystals in joints such as the big toe an hands, sometimes the ears
tophi
220
primary gout has three stages
1) asymptomatic hyperuricemia
2) Acute gouty arthritis
3) chronic gout
221
primary gout can be
genetic
222
secondary gout is caused by
another disease that causes excessive uric acid in the blood
223
treatment for secondary gout focuses on
treating the underlying condition
224
acute gout attacks should subside within
3-10 days
225
this joint is commonly affected by gout pain
metatarsophalangeal joint of the big toe
226
an antigout medication (for acute gout)
colchicine
227
2 other classes of medications that can be used for acute gout
NSAIDs
corticosteroids
228
antigout medication (for chronic gout)
allopurinol
229
MOA allopurinol
promotes uric acid secretion and decreases production or uric acid
230
a uricosuric medication that can be used for chronic gout
probenecid
231
MOA probenecid
promotes secretion of uric acid
232
a client should avoid this food while treating gout
organ meats/shellfish
